For years, the healthcare community has warned of an upcoming physician shortage that may require as many as 130,000 additional doctors by 2020. With access to healthcare now mandated under the Affordable Care Act, and baby boomers retiring, the reasoning seems logical. The media and the public have largely accepted these estimates as fact, until recently. A growing number of health economists and analysts now believe the shortage is not necessarily real, or as significant as predicted.
While there is agreement that the U.S. needs more primary care providers, it is not clear to everyone that those providers have to be doctors. “There are a lot of primary care services that can be provided by a lot of people other than primary care doctors,” says health economist Gail Wilensky. Nonphysician primary care providers can include physician assistants, nurse practitioners, pharmacists and social workers, for example — often working together in teams with a medical doctor.
Some believe that these teams are both better for the patient, and more efficient at providing care. More nonphysician health practitioners, each providing a different set of services, might lessen the need for more primary care doctors and, at the same time, increase access to primary care.
Prior predictions of physician shortages have also been dramatically inaccurate. In the past, when groups have predicted shortages, we have actually wound up with a surplus of doctors, and vice-versa. While some argue that it is better to be safe than sorry, and have more physicians than required, Wilensky believes that is a significant amount of training time and cost — both personal and systemic — for positions that may not be needed.